Kornimate/medical-research-clean huggingface dataset:
effects of positive end-expiratory pressure on biventricular function during one-lung ventilation

Conditions: Lung Cancer

Summary: one lung ventilation (olv) is essential during thoracic surgery. during olv, intrapulmonary shunt can be increased resulting hypoxemia. wang et al measured intrapulmonary shunt by transesophageal echocardiography. although olv technique had been advanced so far, hypoxemia during olv reaches about 10% in spite of inspired oxygen fraction 100%. applying peep(positive end-expiratory pressure) at dependent lung and cpap at non-dependent lung can mitigate the hypoxemia. above all, peep can be easily applicable. however, there are controversial studies whether it is supportive or not. in this prospective, cross-over study, the investigators are planning to investigate the effects of peep on intrapulmonary shunt, oxygenation and cardiac function as well.


Eligibility criteria:
inclusion criteria: * scheduled for vats lobectomy * 40 ≤ age ≤ 80 * american society of anaesthesiologists(asa) physical status classification i\~iii exclusion criteria: * american society of anaesthesiologists(asa) physical status classification iv * nyha class iii\~iv * severe obstructive lung disease and/or restrictive lung disease patients * those with end-organ diseases (i.e. heart failure, respiratory failure, hepatic failure, renal failure) * arrhythmia * esophageal varix * pregnant women
safety and pharmacokinetics of besylsartan tablet in healthy male subject

Conditions: Hypertension

Summary: this clinical trial was evaluated to compare the safety and pharmacokinetics of besylsartan with amosartan, which was available commercially after single oral dose in healthy male subjects.


Eligibility criteria:
inclusion criteria: * body mass index (bmi) between 18 and 30 * healthy as determined by a responsible physician exclusion criteria: * history of clinically significant disease * any chronic disease * creatine clearance less than 50ml/min * hypotension (100mmhg/60mmhg) * treatment of barbital type drug within 1 month * administration of herbal medicine within 7 days
dartmouth-hitchcock greencare registry for total knee replacement

Conditions: Arthroplasty, Replacement, Knee

Summary: evolving reimbursement policies are driving health systems to improve quality and efficiency. transitioning to an electronic health record (ehr) provided dartmouth-hitchcock medical center (dhmc) an opportunity to redesign staff roles and care path for total knee replacement (tkr). the organization implemented a coordinated team-based care delivery model that integrated real-time measurement of: (1) compliance with trusted guidelines, (2) process of shared decision-making (sdm), and (3) use of patient-reported outcomes (pros). the investigators present the implementation protocol and data.

patient-reported outcome measures were completed 1 month preceding tkr and also at 1 and 12 months following surgery. the primary outcome was change in physical function from baseline to 1-year following surgery in the physical component summary (pcs) of the veterans-rand (vr-12) survey. preoperative measures were: (1) general demographics (patient age, sex, height, weight, body mass index (bmi); (2) treatments tried before surgery; (3) health habits (tobacco use, alcohol use); (4) pre-existing medical conditions (charlson score); (5) physical exam findings (knee range of motion, knee laxity); (7) lab tests (hemoglobin); and (7) radiographic measures (severity of osteoarthritis on standing x-rays). secondary outcomes included physical score (ps) of the patient reported outcome measurement information system global survey (promis-10), knee function (knee osteoarthritis outcome score, koos), safety (reoperations, readmissions, emergency visits, and infection) and measures of patient experience (clinician group and hospital consumer assessment of healthcare providers and systems).

Eligibility criteria:
inclusion criteria: * scheduled tkr * osteoarthritis of the knee exclusion criteria: * previous tkr on the affected knee * diagnosis other than osteoarthritis * age less than 18 years * declined consent

Keywords: knee arthroplasty total knee replacement knee osteoarthritis patient-outcomes measurement program surgical registries shared decision making patient reported outcomes patient experience cohort studies
communities fighting covid-19!

Conditions: Covid19

Summary: to create and evaluate effective covid-19 testing uptake strategies that focus on underserved individuals who are exposed but have not accessed testing, and underserved individuals who are not routinely tested because they are unaware of their exposure or risk status in order to increase testing among these populations and reduce covid-19 related disparities.

communities fighting covid is a partnership between san diego state's school of public health and numerous communities in san diego focused on providing community-based testing to specific language-speaking communities and vulnerable populations. this partnership is funded by the national institutes of health (nih) rapid acceleration of diagnostics-undeserved populations (radx-up), with the aim of ensuring all americans have access to timely covid-19 testing and diagnosis. many communities, particularly immigrant and people of color communities, have a harder time accessing existing covid-19 resources due to transportation, language barriers, or other barriers.

Eligibility criteria:
inclusion criteria: * african american, arabic speaking, filipino, and latino/a populations exclusion criteria: * younger than 6, not in focus populations
quantiferon for detection of latent tuberculosis in healthcare workers

Conditions: Tuberculosis

Summary: the accuracy of tuberculin skin test (tst) for detecting latent tuberculosis is limited in countries with a high proportion of population having received vaccination with the bcg. we aim to determine the cost-effectiveness of quantiferon gold (qtfg), compared to bcg vaccine to detect latent tuberculosis in exposed healthcare workers (hcws)

the quantips study includes two components: 1. survey of hcws working in high-risk units (respiratory diseases or infectious diseases with at least 5 case of smear-positive pulmonary tuberculosis par year) from 14 university hospitals in france 2. follow-up of hcws with unexpected exposure to a patient with contagious tuberculosis (delay in respiratory isolation of a smear-positive patient) in 4 university hospitals main objective: therapeutic impact of tuberculosis screening using tst compared to qftg. the impact is defined by the decision to treat of not a hcw with latent tuberculosis using qftg, compared to the decision which would have been based on tst alone secondary objectives: * cost-effectiveness of replacing tst by qftg * prevalence and incidence of latent tuberculosis in exposed hcws (part 1) * incidence of latent tuberculosis in hcws exposed to an index case (part 2) inclusion: hcws who volunteer to participate in units with at least 5 patients with smear-positive tuberculosis each year (group 1), hcws exposed to a smear-positive patient non isolated at hospital admission (group 2) study population: 2000 (group 1) and 600 (group 2) hcws study duration: inclusion during 3 months, follow-up of one year (group 1 ); inclusion for one year, with a 3-month follow up (group 2) study exams: * group 1 : tst, qftg, chest radiography at baseline and after one year * group 2 : tst, qftg, chest radiography at baseline (within 3 weeks after exposure) and after 3 months endpoints: * therapeutic decision regarding tuberculosis treatment, with a cost-effectiveness analysis (markov's modelling) * prevalence and incidence of latent tuberculosis

Eligibility criteria:
inclusion criteria: group 1: * healthcare worker volunteering for the study * stable (expected employment in the unit \> one year) * working in a high-risk units for tuberculosis (at least 5 cases of smear-positive pulmonary tuberculosis per year) group 2 : * healthcare worker volunteering for the study * with an unexpected exposure to a patient with contagious tuberculosis (delay in respiratory isolation of a smear-positive patient) exclusion criteria: * no informed consent * age \< 18 years * employment in this unit \< one year

Keywords: occupational diseases tuberculosis tuberculin test immunoassay
low tidal volume ventilation with hyperoxia avoidance during cardiopulmonary bypass (the focus trial)

Conditions: Cardiac Surgery

Summary: this is a multi-institutional study (ccf, upmc, osu) evaluating different ventilation strategies during cardiopulmonary bypass on mortality and postoperative pulmonary complications, with sub-study investigating 8-iso-prostaglandin f2a and srage levels.

the investigators will evaluate the effect of low tidal volume with varying fio2 fractions during cardiopulmonary bypass on postoperative mortality and pulmonary complications. this will be a prospective, pragmatic, cluster randomized trial including all eligible adult cardiac surgical patients requiring cardiopulmonary bypass. each week, all operating rooms will be randomized to one of three possible ventilation strategies during the period of cardiopulmonary bypass: 1) continuous low tidal volume ventilation with inspired oxygen fraction at 1.0, 2) continuous low tidal volume ventilation with inspired oxygen fraction at 0.21, and 3) no ventilation (apnea). the investigators will anticipate increase in plasma srage and 8-iso-prostaglandin f2a levels in all three groups of patients during cpb with the highest levels immediately after cross-clamp release. the investigators will anticipate significant difference with at least 25% lower srage levels in this group. the sub-study will also provide preliminary data on the behavior of the 8-iso-prostaglandin f2a which will be useful in further investigation of other targeted interventions to reduce ischemia-reperfusion injury to the lung during routine cardiac surgical operations.

Eligibility criteria:
inclusion criteria: * \>18 years of age * male and female patients undergoing elective cardiac surgeries requiring cardiopulmonary bypass. exclusion criteria: emergency surgeries, surgeries requiring lung isolation and one-lung ventilation (olv), heart or lung transplants, and mechanical circulatory support device implantation pulmonary thrombendarterectomies. * surgeries requiring one-lung ventilation will be excluded because of the inability to employ study intervention and the differential treatment of the lungs likely confounding any potential effect from the planned intervention. * lung transplant surgeries will be excluded for similar reasons as well as other confounding effects affecting the primary composite outcome. * heart transplants and mechanical circulatory support device implantation surgeries will be excluded because these patients already receive intervention as part of the institutional protocol at the primary study site.
pulmonary ultrasound in the diagnosis of acute thoracic syndrome in vaso-occlusive sickle cell crisis

Conditions: Sickle-Cell Disease Nos With Crisis

Summary: ats (acute thoracic syndrome) refers to acute pulmonary involvement in a sickle cell patient. the diagnosis is based on the association of clinical signs (fever or respiratory symptoms) with a recent pulmonary infiltrate on the chest x-ray. the main objective of the study is to evaluate the place of the pulmonary ultrasound for the diagnosis of ats, in comparison with frontal chest x-ray.

the ats occurs in half of the cases during hospitalization for a voc (vaso occlusive crisis). the morbidity of ats is important (respiratory insufficiency, duration of hospitalization, stays in intensive care, brain complications, pain, hypoxia, long-term sequelae, etc.) but no study has shown the benefits of curative treatments such as transfusion ( recommended at the time of diagnosis and practiced by some teams) or noninvasive ventilation (practiced by other teams). the first step before studying curative treatments is to have tools for early detection of ats. recent studies show non-inferiority of pulmonary ultrasonography compared to radiography and thoracic computed tomography in the diagnosis of pulmonary condensation (in adults and children). in a study performed in sickle cell adults admitted for ats, pulmonary ultrasound was more sensitive than x-ray in detecting images of pulmonary consolidations visible on the chest ct scan. daswani et al have also shown the value of pulmonary ultrasound in comparison with radiography in the detection of consolidation lesions, suggestive of sta, in febrile children or young adults with sickle cell disease. they showed a good sensitivity (87%) and specificity (94%) of the pulmonary ultrasound.

Eligibility criteria:
inclusion criteria: * age: ≥12 months and \<18 years * has a major sickle cell disease whatever the genotype * admission to hospital for a febrile vaso-occlusive crisis (voc) or not * evolving at home for less than 48h * concomitant treatment with hydroxycarbamide / hydroxyurea possible * signed consent * patients affiliated to a french social security scheme exclusion criteria: * child presenting an acute thoracic syndrome (ats) from the outset at the admission * child who presented an ats in the month preceding the inclusion * child in regular transfusion program or child who has received a hematopoietic stem cell transplant * child hospitalized at least 5 times for voc in the year preceding inclusion (psychic problems making difficult the evaluation of the pain) * child who has already been included in the study during a previous voc (each child participates in the study only once) * voc evolving for more than 48 hours before admission to the emergency room * acute splenic sequestration crisis at admission
prospectively predict the immunotherapy response of gastric cancer based on circulating exosomal lncrna-gc1 biopsy

Conditions: Advanced Gastric Carcinoma; Immunotherapy

Summary: to vertify the function of circulating exosomal lncrna-gc1 on predicting and monitoring immunotherapeutic outcomes of gc

the investigator's previous work identified circulating exosomal lncrna-gc1 as a gc-specific tumor burden marker and this novel biomarker showed promising efficiency in monitoring disease progression during treatment. hence in this stuty, the investigator plan to recruit a prospective cohort to support the conclusions, and provide biomarkers to realize predicting and monitoring immunotherapeutic outcomes of gc.

Eligibility criteria:
inclusion criteria: * having signed informed consent * age≥ 18 years old * histologically confirmed gastric adenocarcinoma * unresectable recurrent or metastatic disease * measurable disease according to the recist criteria * life expectancy of ≥3 month * no prior chemotherapy of the study more than 4 weeks * immunotherapy regimens were included in the treatment exclusion criteria: * other previous malignancy within 5 year * surgery (excluding diagnostic biopsy) within 4 weeks prior to study * pregnancy or lactation period * legal incapacity

Keywords: circulating exosomal lncrna-gc1 advanced gastric carcinoma immunotherapy response
platelet indices in patients undergoing primary pci and its prognostic value

Conditions: Acute Myocardial Infarction

Summary: to assess the platelet indices in patients undergoing primary percutaneous coronary intervention and its relation to the severity of coronary artery disease and short term clinical outcomes

acute coronary syndromes (acs) is a type of acute coronary artery disease (cad), it is a highly prevalent group of emergency diseases, associated with high morbidity and mortality (1) acs include st- elevation myocardial infarction (stemi), non st-elevation myocardial infarction (nstemi) and unstable angina (ua) (2). acs characterized by plaque rupture and acute thrombosis formation in the coronary arteries (3) platelet morphology and function have vital roles in the pathogenesis of many diseases related to coagulation, thrombosis, inflammation, and endothelial dysfunction (4) platelets play a crucial role in thrombotic episodes, its activation is acritical factor in the creation and evolution of atherothrombosis. (5) not only platelets are essential for the thrombotic vascular occlusion at the ruptured atherosclerotic plaque but also they contribute to the obstruction and impairment of coronary micro circulation (6). risk stratification plays a crucial role in the management of patients with acs (7). patients estimated to be at higher risk may be managed with earlier and more aggressive treatment, whereas those with lower risk may be managed with less intensive treatment (8). many biomarkers have been evaluated, and various scores have been created for risk stratification of acs patients (9) mean platelet volume (mpv) has been proposed as a primary marker for platelet activation, as larger sized platelets have been associated with higher pro-thrombotic risk, and its measurement is easy and time effective (10-14) * so it may elevate in patients with acs and its role, it could be a useful bio marker of risk of stratification (15) * platelet distribution width (pdw) measured on admission is a cheap and generally available biomarker which allows for predicting the development of heart failure in patients with acs after pci (16) showed that an increased level of pdw was related to the severity of cad in patients with acs (17). numerous studies support the association of mean platelet volume (mpv) with adverse cardiac outcomes as restenosis stent thrombosis in patients with acs (19-24) al.2011

Eligibility criteria:
inclusion criteria: * adult patients (age ≥ 18 years) that presented with acute st elevation myocardial infarction exclusion criteria: 1. cardiomyopathy, 2. previous revascularization procedure 3. any history of bleeding diathesis
myoring implantation with corneal collagen crosslinking for keratoconus

Conditions: Keratoconus

Summary: a complete intrastromal ring, myoring (dioptex, gmbh, linz, austria), suggested by albert daxer in 2007, is a relatively new technique that has been demonstrated to treat keratoconus safely and effectively.corneal collagen crosslinking (cxl), introduced by wollensak et al. in 2003, has become a standard treatment for progressive keratoconus to slow or possibly stop progression of disease. the formation of the stromal pocket during myoring implantation offers the opportunity for simultaneous introduction of riboflavin 0.1% into the pocket followed by uva irradiation to provide combined treatment in patients with progressive keratoconus.


Eligibility criteria:
inclusion criteria: * \>18 years old * a diagnosis of keratoconus, intolerance for contact lenses or glasses * a documented progression of disease. this progression was defined by the following changes over 1 year: an increase of the steepest k by 1.0 diopter (d) or more in manifest cylinder, or an increase of 0.5 d or more in manifest spherical equivalent (se) refraction by repeated keratotopography odp-scan ark-1000 (nidek, japan) exclusion criteria: * minimal pachymetry of less than 380 μm, * a history of previous ocular pathology or ocular surgery; * pregnancy or breastfeeding; * corneal scarring.

Keywords: keratoconus riboflavin corneal collagen crosslinking intrasromal ring
impact on linkage to hiv care with point of care cd4 testing and home-based hiv testing in kenya

Conditions: HIV

Summary: randomised controlled trial to assess accuracy, feasibility, acceptability, cost effectiveness and impact of point of care cd4 testing on hiv diagnosis, linkage to care and time to antiretroviral therapy initiation among hiv infected patients in rural western kenya.


Eligibility criteria:
inclusion criteria: adults living in the study catchment area (gem village, nyanza province western kenya) served by one of 23 hiv clinics and 3 referral labs * not having received hiv care in prior 6 months if known hiv+ exclusion criteria: * current hiv care or hiv care within last six months

Keywords: linkage to care point of care diagnostics point of care cd4 hiv care cascade kenya
glycine treatment of prodromal symptoms

Conditions: Schizophrenia

Summary: this is an open label trial of the nmda agonist glycine used alone for symptoms that appear to be prodromal for schizophrenia in adolescents and young adults.


Eligibility criteria:
inclusion criteria: * age 14-35 * meets sips criteria for psychosis prodrome exclusion criteria: * current antipsychotic medication * more than 4 weeks of antipsychotic medication lifetime
prostate cancer parameters for patients receiving proton treatment

Conditions: Prostate Cancer

Summary: to prospectively collect data from patients treated with proton therapy for prostate cancer using the iuhptc technique for the evaluation of toxicity and efficacy of this treatment technique.

the major purpose of this study is to analyze side effects experienced and self-reported by prostate cancer patients undergoing proton radiation therapy at iuhptc. with the information collected, the investigators will establish pre-existing conditions before proton treatment and measure side effects after treatments that are not related to the pre-existing conditions. also, to compare long-term side effects for patients who are treated with hormone suppression therapy along with their proton therapy to those patients who do not get treated with hormone suppression therapy. this information will help doctors better understand the side effects experienced and may help provide valuable information for future patients making decisions regarding their treatment options. finally, to develop a database of information regarding the treatment and outcomes for patients with prostate cancer in order to improve care of patients with this type of cancer.

Eligibility criteria:
inclusion criteria: * subjects must have histologically or cytologically confirmed adenocarcinoma of the prostate and are scheduled to receive proton radiation treatment at iuhptc. * subjects with any stage or grade of tumor will be allowed including proton salvage therapy in the context of a rising psa after surgery and a negative metastatic work-up. * prior use of lupron therapy or a similar agent is allowed. use of lupron or similar agent must be for ≤ 6 months prior to enrollment. * use of casodex and agents in the same drug class is allowed. age is ≥ 18 years at the time of consent. * the ability to understand and willingness to sign an informed consent and authorization for the release of health information. exclusion criteria: -evidence of distant metastases at the time of enrollment.

Keywords: prostate proton therapy cancer
single pass albumin dialysis in patients with cirrhosis

Conditions: Cirrhosis; Acute on Chronic Hepatic Failure; Hepatorenal Syndrome; Encephalopathy

Summary: the aim of this study is to determine whether a simplified device of albumin dialysis also has beneficial effects.

albumin dialysis has beneficial effects in patients with acute on chronic liver failure. however, current devices are complex and costly. the aim of this study is to determine whether a simplified device of albumin dialysis also has beneficial effects.

Eligibility criteria:
inclusion criteria: * minimum age of 18 years * written consent after information of the patient or, in case of inability, by a parent or a close if he is present. * patient having a cirrhosis researched by previous exams (liver biopsy) or, in the absence of previous diagnosis, diagnosed in view of the results of clinical, biological and morphological data, whatever the origin of the cirrhosis (virus of hepatitis b, virus of hepatitis c, extreme consumption of alcohol or other reasons) exclusion criteria: * participation to an other study in the 4 weeks before * active digestive bleeding, unchecked by the pharmacological treatments and the endoscopic techniques.

Keywords: albumin dialysis artificial liver support acute on chronic liver failure